A 59-year-old man with poorly controlled type 2 diabetes mellitus (HbA1c 9.2%) presents with a 1-year history of progressive burning pain and numbness in both feet. Vital signs: BP 148/92, HR 88, RR 16, Temp 37°C, SpO2 98%. Examination reveals decreased pinprick and vibration sensation in stocking distribution bilaterally, normal motor strength, and intact deep tendon reflexes. Nerve conduction studies show slowed velocities. Which of the following is the most likely diagnosis?
- A)Bell palsy
- B)Mononeuritis multiplex
- C)Spinal muscular atrophy
- D)Myasthenia gravis
- E)Diabetic distal symmetric polyneuropathyGABARITO
Explicação
Chronic hyperglycemia commonly causes a length dependent distal symmetric polyneuropathy with sensory loss and burning pain in a stocking distribution. Both small and large fibers can be affected over time. Ver explicação completa e trilha adaptativa →